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Multispectral Bimodal Fluorescence Guided Surgery of High-grade Glioma With Cetuximab-800CW and 5-ALA (5-aminolevulinic Acid) (MIRROR)

Primary Purpose

Glioblastoma, High-grade Glioma

Status
Recruiting
Phase
Phase 1
Locations
Netherlands
Study Type
Interventional
Intervention
Cetuximab-IRDye800
Sponsored by
University Medical Center Groningen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Glioblastoma focused on measuring Fluorescence guided surgery, Glioblastoma, High-grade glioma, 5-ALA

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Willing to adhere to the prohibitions and restrictions specified in this protocol. Capable of giving signed informed consent (voluntarily), indicating that the patient understands the purpose and procedures required for the study and is willing to comply with the requirements and restrictions listed in the informed consent form and in this protocol. Patients aged ≥ 18 years inclusive at moment signing informed consent form. Established high-grade glioma (glioblastoma, grade 4 according to the WHO (World Health Organization) classification) and scheduled for surgical intervention. Life expectancy of > 12 weeks. Karnofsky performance status of at least 70%. No clinically significant laboratory abnormalities as determined by the investigator o Note: one retest of lab tests is allowed within the screening window Female patients should fulfil one of the following criteria: At least 1 year post-menopausal (amenorrhea >12 months) at screening Surgically sterile (bilateral oophorectomy, hysterectomy, or tubal ligation) Women >18 years of age who are fertile, need to agree to use an adequate form of contraceptives during and till 3 months after the study. Before study enrollment, a pregnancy test in blood or urine will be performed to rule out a pregnancy. In the case of an unlikely pregnancy during the study, they accept the possible maternal/ fetal risk of participation in the study. Exclusion Criteria: General: Behavioral or cognitive impairment or psychiatric disease that in the opinion of the investigator affects the ability of the patient to understand and cooperate with the study protocol Deprived of freedom by an administrative or court order or in an emergency setting. Insufficient venous access for the study procedures. Close affiliation with the investigator; e.g. a close relative of the investigator, dependent person (e.g. employee or student), employee of the department of Neurosurgery of the UMCG (University Medical Center Groningen), or affiliates Any finding in the medical examinations or medical history giving, that in the opinion of the investigator, leads to a reasonable suspicion of a disease or condition that makes treatment with the investigational drug unadvisable, or that might affect interpretation of the results of the study or render the patient at high risk for treatment complications Participation in an interventional clinical study within 30 days prior to tracer administration that involved treatment with any drug (excluding vitamins and minerals) or medical device Medical conditions Concomitant malignancies, including metastasized colon-, rectal-, breast carcinoma, non-small cellular lung carcinoma (NSCLC); primary epithelial ovarian-, fallopian tube-, primary peritoneal- or cervical carcinoma. Any abnormalities in the vital signs of the patient, as judged by the investigator, as a result of which the patient cannot participate eGFR (based on plasma-creatinine) outside of normal range at screening or known renal impairment (≤40 mL/min). Current evidence or history of bacterial, viral or fungal infections within 7 days before Cetuximab-IRDye800CW administration, as judged by the Investigator. o T > = 38.0°C or lab confirmed viral/bacterial/fungal infection (PCR)) or symptoms suggestive of an infection) Any laboratory test which is abnormal, and which is deemed by the Investigator(s) to be clinically significant A history of anaphylaxis, history of allergic reaction(s), known allergy to one of the drugs or excipients administered as part of this study. Mild allergies without angioedema or treatment need can be acceptable if deemed not to be of clinical significance (including but not limited to allergy to animals or mild seasonal hay fever)

Sites / Locations

  • UMCGRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Glioblastoma group

Arm Description

This study will consist of 1 group and therefore 1 arm

Outcomes

Primary Outcome Measures

Optimal dosage
To determine the optimal dosage of Cetuximab-IRDye800CW for fluorescence guided surgery of high-grade glioma using Near- Infrared (NIR) fluorescence imaging
To assess the safety and tolerability of intravenous tracer administration by measuring/registering the number(S)AEs and SUSARs that have occurred during the duration of the trial
The (S)AEs and SUSARS will be reported according to the CTCAE v4.0
In vivo/ex vivo correlation
To correlate fluorescent signals measured by in vivo multispectral imaging with Cetuximab-IRDye800CW and 5-ALA with those measured by ex vivo imaging

Secondary Outcome Measures

Fluorescent signals vs pathology
To correlate the presence of pathologically confirmed EGFR(epidermal growth factor receptor)-gene amplification with the presence of fluorescence signals, in- and ex vivo, as measured with NIR fluorescent imaging after administering Cetuximab-IRDye800CW.
DSC biomarkers
Correlation between DSC (dynamic susceptibility contrast) biomarkers with pathological EGFR-gene amplification status.

Full Information

First Posted
May 25, 2023
Last Updated
June 26, 2023
Sponsor
University Medical Center Groningen
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1. Study Identification

Unique Protocol Identification Number
NCT05929456
Brief Title
Multispectral Bimodal Fluorescence Guided Surgery of High-grade Glioma With Cetuximab-800CW and 5-ALA (5-aminolevulinic Acid)
Acronym
MIRROR
Official Title
Multispectral and Bimodal Fluorescent Guided Surgery (FGS) of High-grade Glioma for Refining Margin Assessment: A Phase 1 Dose Finding Study Using Cetuximab-IRDye800CW Combined With 5-ALA.
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 5, 2023 (Actual)
Primary Completion Date
October 1, 2024 (Anticipated)
Study Completion Date
January 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Medical Center Groningen

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The MIRROR study is a prospective, single center phase I feasibility and dose finding study in patients with high-grade glioma, to establish the safety, feasibility, and optimal dosage of Cetuximab-IRDye800CW for fluorescence guided surgery, in comparison to the standard of care (SOC), 5-ALA fluorescent imaging agent. The main research objectives of this study are: To determine the optimal dosage of Cetuximab-IRDye800CW for fluorescence guided surgery To assess the safety and tolerability To correlate fluorescent signals measured by in vivo multispectral imaging with Cetuximab-IRDye800CW and 5-ALA with those measured by ex vivo imaging The study population will consist of patients, aged ≥18 years, diagnosed with high-grade glioma and scheduled for surgery.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glioblastoma, High-grade Glioma
Keywords
Fluorescence guided surgery, Glioblastoma, High-grade glioma, 5-ALA

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
prospective, single center phase I feasibility and dose finding study in a single cohort, i.e patients with glioblastoma
Masking
None (Open Label)
Allocation
N/A
Enrollment
21 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Glioblastoma group
Arm Type
Experimental
Arm Description
This study will consist of 1 group and therefore 1 arm
Intervention Type
Drug
Intervention Name(s)
Cetuximab-IRDye800
Intervention Description
patients will receive a single IV injection of Cetuximab-IRDye800CW 2-4 days prior to surgert. The IMP (Investigational medicinal product)/tracer will be used for fluorescence guided surgery.
Primary Outcome Measure Information:
Title
Optimal dosage
Description
To determine the optimal dosage of Cetuximab-IRDye800CW for fluorescence guided surgery of high-grade glioma using Near- Infrared (NIR) fluorescence imaging
Time Frame
1 day
Title
To assess the safety and tolerability of intravenous tracer administration by measuring/registering the number(S)AEs and SUSARs that have occurred during the duration of the trial
Description
The (S)AEs and SUSARS will be reported according to the CTCAE v4.0
Time Frame
4-5 days
Title
In vivo/ex vivo correlation
Description
To correlate fluorescent signals measured by in vivo multispectral imaging with Cetuximab-IRDye800CW and 5-ALA with those measured by ex vivo imaging
Time Frame
1 day
Secondary Outcome Measure Information:
Title
Fluorescent signals vs pathology
Description
To correlate the presence of pathologically confirmed EGFR(epidermal growth factor receptor)-gene amplification with the presence of fluorescence signals, in- and ex vivo, as measured with NIR fluorescent imaging after administering Cetuximab-IRDye800CW.
Time Frame
1 day
Title
DSC biomarkers
Description
Correlation between DSC (dynamic susceptibility contrast) biomarkers with pathological EGFR-gene amplification status.
Time Frame
1 day

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Willing to adhere to the prohibitions and restrictions specified in this protocol. Capable of giving signed informed consent (voluntarily), indicating that the patient understands the purpose and procedures required for the study and is willing to comply with the requirements and restrictions listed in the informed consent form and in this protocol. Patients aged ≥ 18 years inclusive at moment signing informed consent form. Established high-grade glioma (glioblastoma, grade 4 according to the WHO (World Health Organization) classification) and scheduled for surgical intervention. Life expectancy of > 12 weeks. Karnofsky performance status of at least 70%. No clinically significant laboratory abnormalities as determined by the investigator o Note: one retest of lab tests is allowed within the screening window Female patients should fulfil one of the following criteria: At least 1 year post-menopausal (amenorrhea >12 months) at screening Surgically sterile (bilateral oophorectomy, hysterectomy, or tubal ligation) Women >18 years of age who are fertile, need to agree to use an adequate form of contraceptives during and till 3 months after the study. Before study enrollment, a pregnancy test in blood or urine will be performed to rule out a pregnancy. In the case of an unlikely pregnancy during the study, they accept the possible maternal/ fetal risk of participation in the study. Exclusion Criteria: General: Behavioral or cognitive impairment or psychiatric disease that in the opinion of the investigator affects the ability of the patient to understand and cooperate with the study protocol Deprived of freedom by an administrative or court order or in an emergency setting. Insufficient venous access for the study procedures. Close affiliation with the investigator; e.g. a close relative of the investigator, dependent person (e.g. employee or student), employee of the department of Neurosurgery of the UMCG (University Medical Center Groningen), or affiliates Any finding in the medical examinations or medical history giving, that in the opinion of the investigator, leads to a reasonable suspicion of a disease or condition that makes treatment with the investigational drug unadvisable, or that might affect interpretation of the results of the study or render the patient at high risk for treatment complications Participation in an interventional clinical study within 30 days prior to tracer administration that involved treatment with any drug (excluding vitamins and minerals) or medical device Medical conditions Concomitant malignancies, including metastasized colon-, rectal-, breast carcinoma, non-small cellular lung carcinoma (NSCLC); primary epithelial ovarian-, fallopian tube-, primary peritoneal- or cervical carcinoma. Any abnormalities in the vital signs of the patient, as judged by the investigator, as a result of which the patient cannot participate eGFR (based on plasma-creatinine) outside of normal range at screening or known renal impairment (≤40 mL/min). Current evidence or history of bacterial, viral or fungal infections within 7 days before Cetuximab-IRDye800CW administration, as judged by the Investigator. o T > = 38.0°C or lab confirmed viral/bacterial/fungal infection (PCR)) or symptoms suggestive of an infection) Any laboratory test which is abnormal, and which is deemed by the Investigator(s) to be clinically significant A history of anaphylaxis, history of allergic reaction(s), known allergy to one of the drugs or excipients administered as part of this study. Mild allergies without angioedema or treatment need can be acceptable if deemed not to be of clinical significance (including but not limited to allergy to animals or mild seasonal hay fever)
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yester Janssen, MD
Phone
+316 15 17 09 00
Email
y.f.janssen@umcg.nl
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rob Groen, MD, PhD
Organizational Affiliation
University Medical Center Groningen
Official's Role
Principal Investigator
Facility Information:
Facility Name
UMCG
City
Groningen
ZIP/Postal Code
9700RB
Country
Netherlands
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yester Janssen, MD
Phone
+31615170900
Email
y.f.janssen@umcg.nl

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
upon request it can be decided whether data will/can be shared with other researchers

Learn more about this trial

Multispectral Bimodal Fluorescence Guided Surgery of High-grade Glioma With Cetuximab-800CW and 5-ALA (5-aminolevulinic Acid)

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